Tuesday, September 2, 2014

IBM Medicare OneExchange 2014 fall open enrollment

For those of us already enrolled in Medicare, October 15 - December 7, 2014 is the annual open enrollment period.  This, by law, is the federal government's time of year when it allows Medicare recipients to make changes for Medicare Advantage plans and Medicare prescription drug plans to be effective for 2015.  It is NOT an official enrollment time to make changes to Medicare supplemental plans (aka medigap plans).  Medigap plans are regulated by state laws and your state determines when and whether you can switch from one medigap plan to another.  For example, in New York state you can change medigap policies any time you want to be effective the beginning of the next month.  It's called continuous enrollment.
 
What does all this have to do with OneExchange?  You are required to purchase at least one private insurance policy from OneExchange to get your HRA subsidy.  If you bought a Medicare Advantage plan or a drug plan and you are happy with the plan then you don't need to make any changes for 2015 and don't need to talk to anyone at OneExchange.  HOWEVER, you must RELOOK at your plan to be sure it will continue to provide the benefits you want in 2015 and take action if the plan is no longer meeting your needs.
 
This is the time of year private insurance plans make changes to benefits and to formularies (the list of drugs they will cover) for the plans they offer.  Your current plan should send you a notification of changes by the beginning of October.  I suggest that the best way to find out which prescription drugs your plan will cover is on the Medicare website (www.medicare.gov).  Plan updates will be posted on that website by October 15, 2014. That's when to do the "plan finder". Enter your drugs and look at available plans in your zip code that provide the best coverage.
 
If the medical or drug plan you currently have through OneExchange is no longer suitable, you will need to switch to a better OneExchange plan and you MUST make Medicare Advantage or part D insurance plan changes before December 8th since there is no special enrollment period for IBMers this year. The Medicare dates of Oct. 15 - Dec. 7  apply to make those changes. Again, it does not apply to Medicare Supplemental/medigap policies.  You need to talk to your state first to find out the rules for making those changes before you change anything with OneExchange. Unfortunately, switching means going through the OneExchange enrollment process again.
 

4 comments:

  1. Hi, I retired on June 30 with a substantial FHA notional account. However, I have been unable to set up my reimbursement account with OneExchange. Apparently IBM had to "reprocess" all my information in August, but ESC has indicated IBM did send it over in Aug. Now currently on an "IBM issue" log at OneExchange for tracking purposes, but still, 10 weeks after my retirement, have no access to my FHA account at OneExchange. How long does it usually take for an FHA account to be accessible for use by retiree?

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    1. It seems like 10 weeks is much too long. I suggest you call the ESC back and tell them you want to talk to the "Plan Administrator". Tell them this is not a OneExchange issue. It is an IBM issue because you do not have access to your FHA. Push ESC into action. Be persistent about needing to tell the plan administrator what is happening because you need access to that money. ESC call center personnel are not IBM employees. You need to talk to an IBM employee about resolving the delay. ESC is pressured by IBM to resolve issues and my guess is they are measured. If it isn't resolved, there is an address in the plan summary book to write to the plan administrator to file a complaint. That book is available online in netbenefits. Tell ESC to give you the address of the plan administrator because you want to file a complaint. Hope it is quickly resolved.

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  2. It may well have been a coincidence, but 2 days after emailing a letter to Dr Rhee I got a call from OX that my funding had come thru! Yet to be answered: who is the Plan Administrator. Here's the text of my letter:

    Dear Dr. Rhee,

    I am notifying you of my intention to file a formal complaint with the Plan Administrator for the Medicare-eligible FHA/HRA program. I am unable to access any funding even though I have been retired from IBM since July 1, 2014. Frequent calls, conversations and multiple tickets have not resolved this issue. I have an IBM FHA account valued at approximately $32,000. However the transfer to OneExchange is still being processed and I have no access to these funds.

    My IBM Summary Plan Description book January 1, 2014, (USHR 112, page 227) states that IBM Employee Services Center (ESC) is the Plan Administrator. However IBM ESC says they have no visibility into OneExchange processes and that they are no longer the Plan Administrator. When I told ESC I would like to file a formal complaint they insisted they could only send me back to One Exchange, with whom I have discussed this issue numerous times, and at length. The OneExchange person assigned to my case once again told me she is “monitoring” the situation regularly and that the funding will be retroactive to my retirement date. But she cannot tell me when the funds will be available.

    I registered with OneExchange weeks before my retirement and signed up for supplemental Medicare and basic dental insurance, using OneExchange as the agent/broker. I had no problem with their enrollment process. However, I now have substantial premiums, copays and other healthcare expenses that I am paying for out of pocket on my retiree income.

    I can appreciate IBM’s position regarding rising health costs and the need to offload Medicare supplement expenses. I do not appreciate a reimbursement system that I cannot access.

    Can you please give me the name, address and phone number of the Plan Administrator so I can lodge a complaint to the appropriate executives (not another “ticket”) to expedite resolution?

    Thank you in advance for your assistance.

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    1. Sorry - I misread your posting. You have already been able to email Rhee and you got your money. OK ... if you still want to raise an issue I suggest to send a letter (snail mail) to the Plan Admin address and email Rhee telling him you have sent them a complaint because this whole process has been onerous. If I read the plan summary properly, it says 3 IBM executives are assigned to review situations. I will guess those people are lawyers.

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